Tran Sophia, Killeen Daniel E, Qazi Shafeen, Balachandra Sanjana, Hunter Jacob B
University of Texas System, Austin, Texas, USA.
Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Otolaryngol Head Neck Surg. 2021 Jan;164(1):182-187. doi: 10.1177/0194599820937970. Epub 2020 Jul 7.
To assess whether medication use, specifically statin, metformin, and aspirin, affects the growth of vestibular schwannomas (VSs).
Retrospective case series.
Single tertiary care academic hospital.
Patients were enrolled if they were diagnosed with sporadic VS and had at least 2 magnetic resonance imaging (MRI) studies at a minimum of 6 months apart prior to any intervention. Electronic medical records were reviewed for demographic and medication data. Tumor volumes on MRI studies were assessed via BrainLab iPlan. The primary endpoint was VS tumor growth, defined as a 20% increase in tumor volume, between consecutive MRI studies or between the first and last available MRI study. Predictors of volumetric growth, specifically statin, aspirin, or metformin use, were analyzed with tests, chi-square test, univariate logistic regression, and multivariate logistic regression.
A total of 387 patients met inclusion criteria, 53.5% of whom were women. For all patients, the mean age was 60.6 years (range, 18.2-89.2 years); the mean axial tumor diameter, 11.9 mm (range, 1.7-32.0 mm); and the mean tumor volume, 0.85 cm (range, 0.01-13.1 cm). In review of the electronic medical record, 46 patients (11.9%) were taking metformin; 145 (37.5%), a statin; and 117 (30.2%), aspirin. Among patients taking metformin, 39.1% (18/46) exhibited volumetric growth, as opposed to 58.2% (198/340) of nonusers ( = .014). Metformin (odds ratio, 0.497; = .036) is significantly associated with reduced VS growth when controlling for aspirin, statin, and tumor size on multivariate logistic regression.
Metformin use is associated with reduced volumetric VS growth.
评估药物使用，特别是他汀类药物、二甲双胍和阿司匹林，是否会影响前庭神经鞘瘤（VS）的生长。
回顾性病例系列研究。
单一的三级医疗学术医院。
纳入诊断为散发性VS且在任何干预之前至少有间隔6个月的2次磁共振成像（MRI）检查的患者。查阅电子病历以获取人口统计学和用药数据。通过BrainLab iPlan评估MRI检查中的肿瘤体积。主要终点是VS肿瘤生长，定义为连续MRI检查之间或首次与最后一次可用MRI检查之间肿瘤体积增加20%。使用检验、卡方检验、单因素逻辑回归和多因素逻辑回归分析体积增长的预测因素，特别是他汀类药物、阿司匹林或二甲双胍的使用情况。
共有387例患者符合纳入标准，其中53.5%为女性。所有患者的平均年龄为60.6岁（范围18.2 - 89.2岁）；平均肿瘤轴向直径为11.9 mm（范围1.7 - 32.0 mm）；平均肿瘤体积为0.85 cm³（范围0.01 - 13.1 cm³）。查阅电子病历发现，46例患者（11.9%）正在服用二甲双胍；145例（37.5%）服用他汀类药物；117例（30.2%）服用阿司匹林。在服用二甲双胍的患者中，39.1%（18/46）出现体积增长，而非使用者为58.2%（198/340）（P = 0.014）。在多因素逻辑回归中，控制阿司匹林、他汀类药物和肿瘤大小后，二甲双胍（比值比，0.497；P = 0.036）与VS生长减少显著相关。
使用二甲双胍与VS体积增长减少有关。
